PMID- 18082517
OWN - NLM
STAT- MEDLINE
DCOM- 20080207
LR  - 20071217
IS  - 0002-9149 (Print)
IS  - 0002-9149 (Linking)
VI  - 100
IP  - 12
DP  - 2007 Dec 15
TI  - Effect of thrombocytopenia on outcomes following treatment with either enoxaparin 
      or unfractionated heparin in patients presenting with acute coronary syndromes.
PG  - 1734-8
AB  - Thrombocytopenia is associated with an increased risk for adverse cardiac events 
      and bleeding in patients presenting with acute coronary syndromes (ACS) treated 
      with unfractionated heparin (UFH). Enoxaparin has been shown to improve outcomes 
      in ACS; however, its effect on the development of thrombocytopenia in this 
      population is not well documented. This study was conducted to examine the 
      incidence and clinical importance of thrombocytopenia in patients presenting with 
      non-ST-elevation ACS randomized to treatment with enoxaparin or UFH. 
      Thrombocytopenia was defined as a platelet count <100 x 10(9)/L or a >50% 
      decrease from baseline. Thrombocytopenia developed in a total of 93 of 3,910 
      patients during the follow-up period of 14 days; the incidence was similar 
      between study arms. The development of thrombocytopenia was associated with more 
      frequent death, nonfatal myocardial infarction, and urgent revascularization 
      during the study period (odds ratio 2.96, p = 0.001). This association was 
      independent of assignment to treatment with enoxaparin or UFH (p for interaction 
      = 0.47). Major bleeding was also more common in patients with thrombocytopenia 
      regardless of treatment. In conclusion, thrombocytopenia is a significant 
      correlate of adverse events in patients presenting with non-ST-elevation ACS 
      treated with either enoxaparin or UFH.
FAU - Yeh, Robert W
AU  - Yeh RW
AD  - Department of Medicine, University of California, San Francisco, San Francisco, 
      California, USA.
FAU - Wiviott, Stephen D
AU  - Wiviott SD
FAU - Giugliano, Robert P
AU  - Giugliano RP
FAU - Morrow, David A
AU  - Morrow DA
FAU - Shui, Amy
AU  - Shui A
FAU - Qin, Jie
AU  - Qin J
FAU - Scirica, Benjamin
AU  - Scirica B
FAU - Bradner, James E
AU  - Bradner JE
FAU - Jang, Ik-Kyung
AU  - Jang IK
FAU - Gibson, C Michael
AU  - Gibson CM
FAU - Antman, Elliott M
AU  - Antman EM
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20071029
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Acute Coronary Syndrome/*drug therapy/*epidemiology
MH  - Aged
MH  - Anticoagulants/*therapeutic use
MH  - Comorbidity
MH  - Enoxaparin/*therapeutic use
MH  - Female
MH  - Heparin/therapeutic use
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Recurrence
MH  - Thrombocytopenia/*epidemiology
EDAT- 2007/12/18 09:00
MHDA- 2008/02/08 09:00
CRDT- 2007/12/18 09:00
PHST- 2007/02/12 00:00 [received]
PHST- 2007/07/01 00:00 [revised]
PHST- 2007/07/01 00:00 [accepted]
PHST- 2007/12/18 09:00 [pubmed]
PHST- 2008/02/08 09:00 [medline]
PHST- 2007/12/18 09:00 [entrez]
AID - S0002-9149(07)01669-4 [pii]
AID - 10.1016/j.amjcard.2007.07.036 [doi]
PST - ppublish
SO  - Am J Cardiol. 2007 Dec 15;100(12):1734-8. doi: 10.1016/j.amjcard.2007.07.036. 
      Epub 2007 Oct 29.